Autism Spectrum Disorder
Journal Review Assignment
This paper was prepared for OCT213, Section D1, taught by Karyn Shenker-Gould
Autism Spectrum Disorder
Journal Review Assignment
Autism spectrum disorder (ASD) is a group of developmental disorders that challenges a child’s skills in social interaction, communication, and behavior. ASD’s collective signs and symptoms may include: making little eye contact, repetitive behaviors, parallel play, unexplainable temper tantrums, misunderstanding of nonverbal cues, focused interests, and/or sensory overload (National Institute of Mental Health, 2018). Positive symptoms of ASD may reflect above-average intelligence, excellence in math, science, or art, and the ability to learn things in detail.
Prevalence rates for ASD are increasing to 1 in 59 children (Autism Speaks, 2018). A single cause has not been established for the disorder; however, there are risks that can potentially lead to a diagnosis. According to Autism Speaks (2018), genetics, geriatric pregnancies, low birth weight of the child, or having multiple births in less than a year can influence the outcome of a child being born with ASD. It is important to note that there has not been any scientific evidence that proves vaccines cause ASD. Although an individual can be diagnosed at any age, ASD is commonly diagnosed between the ages of two and four. An early diagnosis is important because it can lead to early intervention services. These services enable a child to develop appropriate social and language skills that will lead to a higher quality of life.
The symptoms of ASD can continue to limit a child’s ability to fully participate in their learning environment. The role of an occupational therapy practioner in a school-based setting would be to identify the child’s educational needs and address them through purposeful activities. The purpose of this paper will be centered on treatment through Ayers Sensory Integration (ASI) for school-aged children with ASD. The application of this treatment will be investigated, along with effective ways to communicate information about the disorder to both colleagues and family members. This information can be used to impact future research of ASI by creating a standardization to measure its effectiveness.
Application to Practice
To meet some of the behavioral and social challenges accompanied with ASD, Ayers Sensory Integration (ASI) can be applied to treat the child. The basis of ASI therapy is to address sensory processing difficulties in a child through controlled, individualized sensory experiences and through the use of the “just right” challenge. A sensory diet is one of the techniques derived from ASI that enables a child to participate in these adapted sensory experiences. Treatment will stimulate visual, auditory, tactile, proprioceptive, or vestibular senses depending on a child’s needs. Through a sensory diet, the therapist will suggest appropriate activities that will give the child the sensory input that they need to be able to stay focused or to remain calm. The use of the “just right” challenge in therapy then allows for a child to develop a tolerance to various sensory inputs through proper exposure. Suggested findings conclude that sensory integration interventions may contribute to improved outcomes in individualized goals that may focus on reading and related skills, sensory–motor skills and motor planning, and behavioral regulation (Schaaf et al, 2018).
ASI can be applied to practice in a school-based setting through interventions centered on sensory stimulation. In 2014, a study by Schaaf et al was conducted to show the efficacy of sensory integration therapy on children with autism. The researchers individually personalized sensory motor activities to address proprioceptive sensations, tactile discrimination, and improve praxis (Schaaf et al, 2014). A treatment session in the study included a carpeted scooter and a cushioned area of mats. The child had to pull themselves up a ramp on a scooter board and then roll back down the ramp into multi-textured pillows. This stimulated total body tactile and proprioceptive sensations in order to increase body awareness. The outcome of the study provided evidence that sensory integration therapy can increase a child’s gain in individualized Goals Attainment Scores, a standardized method to measure goals (Schaaf et al, 2014).
There is a multitude of sensory integration strategies that can be used to address ASD symptoms. Each therapy session is individually tailored to meet the child’s needs. Some intervention tools might include sensory putty, a trampoline, a vestibular swing, or rice. Therapy sessions may also include the use of visual schedules to provide structure for the child. According to Cramer et al (2011), transition times between tasks decreased by 61%. Visual schedules are beneficial because they provide consistency. A predictable routine for a child with ASD can lead to a reduced amount of behavioral problems (Cramer et al, 2011).
Social stories are another method of visual learning that can benefit a child with ASD because it gives the child the resources to manage overwhelming social situations and it can aid in behavior modification. “Each social story is designed to teach children with autism how to manage their own behavior during a given social situation by describing where the activity will take place, when it will occur, what will happen, who is participating, and why the child should behave in a given manner” (Scattone et al, 2002). In a 2002 study by Scattone et al, individualized, social stories were used on three children with ASD. All three participants showed a reduction in disruptive behavior over the course of the nine-week study. Presentation to Colleagues
A child with autism can experience difficulties learning due to sensory processing difficulties. They may be caused by hyper/ hypo response to sensory stimulation in their environment. In the classroom, this might cause the inability to listen to directions, trouble writing, or problems sitting/standing for a period of time. An occupational therapy practioner can intervene by giving the teacher suggestions for adaptations for the student in the classroom.
In a school-based setting, collaboration between an occupational therapy practioner and the teacher is essential. The first thing to do is establish rapport with the teacher. Spending time in the classroom, communicating in short emails, or asking the teacher for his/her own opinion can accomplish this. Building this relationship is important because it allows the teacher and the therapist to trust each other, share observations, and be open to suggestions from one another.
In order to educate the teacher on effective interventions, it will be helpful for the occupational therapy practioner to first explain what sensory processing disorder is and how it has been affecting the student’s classroom behavior. It may be as simple as providing an explanation that overstimulation of the senses requires the student to have to pick which sense they can focus on. After contextual information is given, the practioner can act as a resource and provide different options that the teacher can use in their classroom. It is important to reiterate that each child is different, meaning that one suggestion may work well for one student but not another. Suggestions that can be given may include earplugs, a fidget, a weighted vest, a stress ball, or seating the child away from the door/windows to limit distractions (Autism Speaks, 2018). These sensory accommodations can allow the student to focus on a classroom task.
Education of Families
An important part of helping a student with ASD succeed in the classroom is educating the caregivers. The role of occupational practioner would be to update the caregiver on child’s progress level and contact the parents to offer support through home-based suggestions and community resources. Contact can be made through an in-person discussion, IEP meetings, email, or written recommendations sent home with the child. When speaking to a caregiver, it is important to speak in laymen’s terms and listen to their concerns.
Schedules at home will have to be modified to benefit the child. Ignoring their needs can add stress and lead to a child’s meltdown. Instead, establishing routines would be beneficial because it promotes motivation and stability. For a child with autism and sensory processing dysfunction, a therapist could recommend visual schedules for the parents to go over with the child at home. A study by Bryan and Gast (2000) determined visual schedules were effective in the use of transitions for children with autism and the use of visual schedules promoted independent functioning. Other sensory input ideas parents can potentially incorporate into their child’s daily routine includes crab walk for proprioceptive input, an auditory timer and sensory breaks to complete homework tasks, and/or deep pressure massages or weighted blankets to calm child before bedtime (Jones, 2014). Using therapeutic suggestions in the home will increase a child’s ability to participate and focus in school.
According to Thompson-Hodgetts and Magill-Evans (2018), 98% of occupational therapist used sensory- based approaches on children with ASD and would recommend the approaches for 57% of the children they treated.
ASD is a developmental disorder that’s symptoms affect a person’s ability to participate in activities of daily living, to socialize with peers, and to self-regulate behaviors. Problems with sensory integration can contribute to the negative outcomes of symptoms. In a school-based setting, the role of the occupational therapist is to support and enhance a student’s participation in their educational learning process. Sensory integration therapy can accomplish this goal by addressing symptoms through visual, tactile, auditory, vestibular, or proprioceptive input. The occupational therapist should also involve the student’s teachers and caregivers with sensory-based adaptations in order to help the child succeed in multiple settings. Trust and rapport should be established in these relationships before suggestions are given. Although sensory integration therapy is a common method of treatment, research is still needed to provide evidence-based practice.
Autism Speaks. (2018). What Causes Autism? Retrieved on October 16, 2018 from, https://www.autismspeaks.org/what-causes-autism
Jones, J. (2014, October 21). Five sensory tips to ease the transition back to school. Friendship Circle. Retrieved from http://www.friendshipcircle.org/blog/2014/10/21/five-sensory-tips-to-ease-the-transition-back-to-school/
Schaaf, R.C., Benevides, T., Mailloux, Z. et al (2014). An intervention for sensory difficulties in children with Autism: A randomized trial. Journal of Autism and Developmental Disorders (44): 1493. https://doi.org/10.1007/s10803-013-1983-8
Schaaf, R. C., Dumont, R. L., Arbesman, M., ; May-Benson, T. A. (2018). Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review. American Journal of Occupational Therapy, 72(1), 1–10. https://doi.org/10.5014/ajot.2018.028431Scattone D, Wilczynski SM, Edwards RP, ; Rabian B. (2002). Decreasing disruptive behaviors of children with autism using social stories. Journal of Autism ; Developmental Disorders, 32(6), 535–543. Retrieved from http://search.ebscohost.com/login.aspx?direct=true;db=ccm;AN=106846245;site=ehost-live
Thompson-Hodgetts, S., ; Magill-Evans, J. (2018). Sensory-based approaches in intervention for children with autism spectrum disorder: Influences on occupational therapists’ recommendations and perceived benefits. American Journal of Occupational Therapy, 72(3). doi:10.5014/ajot.2018.024729
Bryan L. C., Gast D. L. (2000). Teaching on-task and on-schedule behaviors to high-functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30, 553–567.